It’s time to act

Reinvigorating family planning is critical to the success of population stabilisation efforts

India’s population has grown from 345 million in 1951 to around 1162 million by May 2009 and is still growing by around 16 to 17 million every year. By all accounts, population growth in India has been rapid and such a massive base and excessiv e growth have important implications for socio-economic development and quality of life. India’s problem of excessive population growth is reflected in widespread hunger, poverty, unemployment, lack of physical and health infrastructure, increasing scarcity of basic resources like food, water and space in several parts of India despite concerted developmental efforts since independence.

Glaring facts

A recent “Global Economic Prospects” report projects that one-fourth of India’s population would be below extreme poverty line, less than $1.25 a day, by 2015. Our official estimates provided by the National Sample Survey in 61st Round based on the Uniform Recall Period methodology yields a poverty ratio of 27.5 per cent for the country as a whole in 2004-05. Despite the declining trend in poverty ratio as per official statistics we still find that around 25 per cent of India’s population (around 29 crore people) still don’t have enough income or resources to afford even two square meals a day. Thus, the massive population base and its rapid growth still continue to be a major challenge to socio-economic progress and sustainable development.

We ought to have a national debate and political consensus and commitment to invigorate family planning efforts, which possibly has been put on the back burner as a population control measure. Possibly, the lack of political commitment to family planning efforts was a result of some excesses during the emergency period i.e. 1975-77; thus the official family planning programme was, dangerously, neglected afterwards. Possibly we have thrown out the baby along with the bath water. Still in India the unmet need for contraception — parents not desirous of having any more children or another child over coming two years, but not using any contraception methods — turned out to be 13 per cent in 2005. Thus, the unmet need for contraception is still substantial.

Coming to India’s total fertility rate of 2.7, as per NFHS-2005, we find the unwanted fertility is around 0.8. Thus, still 40 percent of current fertility or 80 out of 270 children born are unwanted. Simply by accounting the unwanted component we can bring India’s fertility to below replacement level, implying less than two children per couple, which ultimately results into population stabilisation. Obviously, unwanted fertility can primarily be eliminated by meeting the unmet need for family planning. Whereas, reduction in wanted fertility requires investments in human beings, especially in areas of education, child care and public health and thus improvements in quality of life.

Given the wide diversity in population and health transition as well as levels of social and economic development and cultural milieu across the states, strategic options for population stabilisation in India varying from state to state are suggested in India: The State of Population 2007. There is no universal prescription. Regional prescriptions are based on categorization of the constituent states and union territories of India into three categories based on current levels of fertility. The first category comprises five Hindi heartland states and five north-eastern states where fertility levels are well above the replacement level. In these states even the wanted fertility is high – well above the replacement level — and unwanted fertility is also substantial. These states are expected to account for 48 percent of the increase in India’s population between 2001 and 2026.

Collective consensus

The second category states — Jammu and Kashmir, Delhi, Tripura, Assam, West Bengal, Orissa, Gujarat and Maharashtra — are about the reach the two-child goal. Here the wanted fertility is already below the replacement level, two child norms, but the unwanted component is still substantial resulting into higher than replacement level fertility. In these states concerted efforts are needed to provide affordable quality contraception services with informed choice to account for the unwanted component of fertility.

Finally, in the third category — Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Punjab, Himachal Pradesh, Goa and Sikkim — the fertility is already below the replacement level. In these states, population will still continue to increase because of the demographic momentum built into the age structure of the populations. This category of states would contribute around 15 percent of increase in the country’s population during 2001-26.

However, to minimise the impact of demographic momentum we need to increase the mean age of child bearing in these states. Mean age of child bearing can increase firstly because of increase in age at marriage or age at first birth and thereafter usage of spacing methods to increase birth interval between first and next birth. Surprisingly, teenage pregnancies and motherhood is still higher in low-fertility states like Andhra Pradesh and Karnataka compared to even high fertility states like U.P. and M.P. Obviously, physiological immaturity during teenage pregnancies and motherhood results into lot of health problems and also reduces educational and thus employment opportunities for women. Possibly, strict enforcement of the Child Marriage Restraint Act and advocacy of widespread utilization of spacing methods would facilitate minimizing the impact of demographic momentum and also reduce teenage pregnancies and motherhood which have serious social, economic, emotional and health implications.

Reinvigorating family planning is critical to the success of population stabilisation efforts in all the states, in whichever phases of socioeconomic and demographic transition it is. It is, however, important to note that the family planning programme must be adaptive to changing compositional needs of family planning methods in different states in different stages of demographic transition.

The writer is with the Population Research Centre, Institute of Economic Growth, University of Delhi.